Medical application form

This form is for housing register applicants who have a medical condition that needs to be taken into consideration as part of their application, or who live with someone (who is named on your application) that has a medical condition that needs to be taken into consideration as part of their application.

Once the form has been completed, please send the form and any relevant evidence to [email protected]

Some examples of why you might be affected by your current home:

Following a recent accident, an applicant has become reliant on a wheelchair, but they live in a first-floor flat that is not served by a lift

A child has been diagnosed with severe ASD and needs his/her own bedroom due to being violent towards siblings

A wheelchair user lives in a property arranged over more than one floor and needs easy access bathing facilities, but lives in a private sector rental property and the landlord has refused to allow a stair lift to be installed or does not agree to the bathroom being adapted.